Night shift at 35 weeks

“Medicine remains a conservative profession with a rigid structure of practice and one parent at a time we are changing that to be a bit more flexible to parents needs.”

– Bridget Johnson (Motherhood and Medical Training)

A pregnant doctor is an anomaly. Walking the hallways wearing scrubs with a pregnant belly, you feel somewhat out of place and the looks are a mix between pity and shock. I wonder if a pregnant glow can really be appreciated under the fluorescent clinical lighting of a hospital? So what is it like to work as a resident when you’re pregnant? In one word – hard – but for more detailed and descriptive words (and a few handy hints for negotiating a pregnancy while doing hospital work), read on…

As it was my third pregnancy, the ailments of the first trimester never came as a shock. However, they were more challenging when faced in the midst of a normal work day in a busy hospital. The fact that you’re not showing and not telling others that you’re pregnant, only amplifies the challenge. The morning sickness in this pregnancy was the worst I had ever had, but whether it was a unique blend of raging hormones or the morning sickness mixed with resident duties, I cannot say. Certainly one of the worst things about pregnancy sickness is the sensitivity to tastes and smells. The hospital has a very exceptional set of these. Imagine the unfiltered joy of assisting in a liver transplant for several hours, when at the time, something as mild as the smell of toast was making you nauseated. I actually avoided the whole of level 4 of the hospital for 4 months because the smell of the pantry items stored in the café there caused me to vomit one too many times while waiting for the lifts. The best prevention for this was small frequent snacks and ensuring one never gets hungry, as this makes the nausea ten times worse. You are invariably close to hypoglycaemia throughout your shifts when pregnant and others who have been pregnant JMOs will attest to the fact that you will push yourself to finish that task or ward round before you ask for time out. However, it is no secret that you’re pregnant and why we feel the pressure to battle through is really quiet absurd! To mediate your nausea you absolutely need to have your body prepared before you walk past a hospital trolley full of patients’ scrambled eggs interspersed with the smells of antiseptic and other bodily fluids.

Fatigue is a constant battle in every resident’s life and pregnancy does not make that battle any easier. Long ward rounds or time spent upright was like combating tiredness from three days of not sleeping. People want to know, are you treated differently when you’re pregnant in the hospital? Certainly you get no preferential treatment. You are expected to attend to your duties at the same capacity. Yes you still do night shift – something that everyone hates but it cannot be avoided even in pregnancy. I did a whopping 25 night shifts over my last term before maternity leave which was more than exhausting. There are all the usual things that are bad on night shift and then there are all the things that are extra bad because you’re pregnant. The desk chairs are more uncomfortable, you have an insatiable hunger 24 hours a day, you’re increasingly immobile (which makes running to sick patients harder and harder), and your pregnancy brain magnifies your tired brain so you need to work harder to keep yourself even more focused. Sleep is even sweeter after a night shift with an extra load squeezed into your ever tightening scrubs. I was senseless enough to not bother notifying about my pregnancy before the roster was made for my last term, but I would recommend doing this to try and secure a roster that can reasonably be expected for the stage of the pregnancy. For example, being rostered to nights at 35 weeks isn’t ideal! So while you’re not treated differently, sometimes that’s just the issue. Be warned that navigating rostering and pregnancy is not easy or full of concessions. It is not a shock to anybody that the medical profession lacks in its support of pregnant employees and you become your biggest advocate.

As your belly grows, so too do the offers of a chair to sit on while accessing a computer (although I can’t say this happened 100% of the time!). On my last rotation we were able to occasionally take the option of a board handover instead of a bedside one, which was such an appreciated treat! These are the perks of pregnant doctoring, but another point of difference is how patients react to you. You’re invariably off topic when conversing with them because talk quickly deviates to baby chat. Also it seems you have this automatic air of legitimacy where patients perceive you as more ‘grown up’ and serious. Others have found that comments about their appearance and weight gain become a tedious and confronting part of doctoring throughout this period and it is very hard to set boundaries with patients and peers around the dialogue that is appropriate when discussing someone’s body – pregnancy does not give automatic permission to openly make comments.

But how do your colleagues react to you? There was never a time while working that I felt others viewed me as incapable due to the pregnancy, but I think due to the rarity of pregnant doctors, that in yourself you feel insecure about the perceptions of others. There is an unsaid pressure to perform at an untainted level because you don’t want judgment for trying to work as a doctor while pregnant and not handling it. Besides being adamant about ensuring that I had a break to eat during the shift, it’s hard to say to your peers that you’re really tired and need a break – to just have a break – or that your pelvis feels like it’s about to explode so you might need a breather. But pregnancy is nothing to apologise for and it’s a choice that should be celebrated and supported. The gender gap in male versus female doctors is steadily closing [1] and the medical profession needs to start supporting women to be women in the workplace instead of treating motherhood as one individual’s terrible choice. Before I was obviously pregnant, I remember a conversation in which I was congratulated for having two children before my training, so that now I could have my career without the interruptions of pregnancy and early childhood rearing. However, this emphasises a general failure to realise that family building is a personal decision that not only transcends career progression but provides me with personal growth that brings me closer to the doctor I strive to be.

In terms of support it is certainly important to be well versed in your contractual rights in regards to maternity leave. Your union will be well placed to advise you on matters such as this. Also speak to your JMO manager as early as practical to organise your leave in line with your own clinical learning and progression goals. The earlier they are aware, the earlier plans can be put in place. Important things to think about include how long you would like to work into the pregnancy, how long you would like to take off, if you will need to reapply for your position if your contract lapses during this time and what term will be most bearable for working at each stage of your pregnancy. Assisting with transplants for hours when tired and nauseated is not ideal and I can imagine that a working environment such as the emergency department in late pregnancy would also be quite a challenge. Also, be sure to consider if you’ll need to be sitting exams or doing interviews close to your due date, and whether pregnant or nursing, be sure that you’ve got supports in place to undertake these with as little stress as possible.

If you become pregnant in your training years, hopefully you’ll feel supported and feel slightly more prepared for the realities of pregnant doctoring. And if you have a colleague who’s pregnant, be sure to offer them a chair or send them for a lunch break – trust me, growing a human is even harder on night shift at 35 weeks but it’s totally worth it!

About The Author

Resident at Royal Prince Alfred Hospital. Talila has a Bachelor degree in Medicine and Surgery from the University of Sydney in addition to a Bachelor of Science in which she majored in psychology. Talila has two children and was the only Indigenous graduate in the class of 2016 in the Sydney Medical Program. During her undergraduate years Talila worked in the Faculty of Economics and Business at Sydney University, The Garvan Institute and Moreton Consulting. Talila is passionate about Indigenous social justice, health care education, being a mum and cooking.